Individual
HALEY BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2909 N TRENTON ST, RUSTON, LA 71270-2443
(318) 202-3977
Mailing address
2909 N TRENTON ST, RUSTON, LA 71270-2443
(318) 202-3977
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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